Historically, gastrointestinal (GI) surgery has been performed to create a channel between two viscera for the purpose of redirecting bodily fluids, i.e., an anastomosis. It will be recognized that there may be a need to anastomose many different viscera, such as the jejunum and the stomach (gastrojejunostomy), the bile duct and the duodenum, two sections of the small or large intestines, or various other combinations of viscera such as during bariatric surgery.
During surgery to form an anastomosis, the two tissues are often brought together and affixed to one another using fixators such as sutures, staples, or some other fixation means. While fixators are being placed, the tissues of the respective viscera are held in proximity to one another using various means. In open surgery, this is usually accomplished with graspers, forceps, or other tissue holding instruments manipulated by clinicians. In laparoscopic surgery, similar instruments may be used, except the laparotic access limits the number of instruments to a few percutaneous “ports,” making the technical challenge of the procedure much greater.
When these types of GI surgery are performed, there exists the potential to breach the mural boundary. Thus, extreme care must be taken to prevent contamination of the pleural and abdominal cavities with GI contents, which are laden with bacteria that do not naturally occur in those locations. If significant contamination occurs, then serious infection can set-in, which can lead to serious illness or death if not treated early and vigorously.
To address some of these limitations and to minimize the invasiveness of such surgeries, magnetic anastomosis devices (MADs) were developed for forming anastomosis. For example, a MAD may consist of two magnet cores surrounded by metal rims. The two magnet cores are positioned in the two viscera between which the anastomosis is desired. Due to the magnetic attraction between the cores, the walls of the two adjacent viscera are compressed. The compression of the walls of the viscera results in ischemic necrosis to produce an anastomosis between the two viscera. When using MADs, it is sometimes necessary to conduct a second procedure to insert a stent or other device to maintain the anastomosis that the MADs created. A second procedure requires additional costs, patient and physician time, and involves certain risks associated with any endoscopic procedure. Also when using MADs, the distal magnet must be placed in the intestine, usually the jejunum, which requires the use of an intestinal lumen. For patients with tumors or strictures, it may be difficult for an endoscope and/or the distal magnet to pass through. In addition, when using MADs an anastomosis is created over a several day period, rather than being created immediately at the time of the procedure.